{"id":4418,"date":"2018-06-28T18:35:47","date_gmt":"2018-06-28T23:35:47","guid":{"rendered":"https:\/\/cardiologynownews.org\/?p=4418"},"modified":"2018-06-29T08:25:54","modified_gmt":"2018-06-29T13:25:54","slug":"adverse-change-in-employment-is-related-to-poor-outcomes-after-acute-mi","status":"publish","type":"post","link":"https:\/\/cardiologynownews.org\/?p=4418","title":{"rendered":"Adverse Change in Employment Is Related to Poor Outcomes After Acute MI"},"content":{"rendered":"

Adverse change in employment after myocardial infarction (MI) is associated with a lower quality of life, increased depression and more difficulty affording medications according to a study that has been published in the June issue of\u00a0Circulation Cardiovascular\u00a0Quality and Outcomes<\/a><\/em>\u00a0.<\/p>\n

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MI is the most common cardiovascular disease that leads to mortality and morbidity. There has been a\u00a0significant improvement in clinical outcomes\u00a0due to\u00a0advances in prevention and treatment strategies.\u00a0However, the progress in the daily life of the patients does not seem to be as good as clinical outcomes.\u00a0According to some single-center studies in the past literature, more than 30% of the post-MI patients were unable to return to work in 1 year.<\/p>\n

In this study, Haider J. Warraich M.D. and colleagues aimed to assess the prevalence of adverse change in employment after MI. They also planned to compare patient-reported depression, quality of life, medication adherence, and financial hardship in affording medications between patients who had an adverse change in employment and those who were still working at 1 year without an adverse change. The definition of adverse change in employment was patients working at\u00a0the time of index MI but working less or not working at 1-year post-MI.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

To examine this, the authors worked on the data of TRANSLATE-ACS (Treatment with Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events after Acute Coronary Syndrome) registry to evaluate patients treated for an acute MI in 233 US hospitals. 9319 patients were assessed for employment status at the time of index MI (baseline) and 1-year post MI. 4730 patients (51%) were working at baseline.\u00a0When followed up at 1 year, 10% (n=492) of them experienced an adverse change in employment status. 3%\u00a0(n=143)\u00a0of them were\u00a0noted as<\/em> working less and 7%\u00a0(n=349)\u00a0were no longer working. A total of 172 out of the 349 patients who were no longer working reported an involuntary job loss.<\/p>\n

Patients who had an adverse change in employment were more likely to be women, with diabetes mellitus, hypertension, tobacco use, and were less likely to have a drug-eluting stent than patients who remained working as before. Importantly, patients with an adverse change in employment were more likely to have recurrent MI (5.9% vs 2.2%; p< 0.001), unplanned revascularization (13.8% vs 7.9%;\u00a0P<\/em>\u00a0< 0.001), stroke (0.8% vs 0.3%; p= 0.03), and bleeding (24.4% vs 17.6%; p< 0.001)\u00a0than patients who were still working.\u00a0Factors significantly associated with adverse change in employment included the number of unplanned readmissions (OR: 1.20 \u00a095% CI,\u00a01.09\u20131.32), post discharge bleeding complications (OR: 1.39 95% CI, 1.13\u20131.72), hypertension (OR: 1.33 95% CI, 1.08\u20131.65), and smoking (OR: 1.28 95% CI, 1.04\u20131.57).\u00a0The strongest factor associated with adverse change in employment in the 1 year after discharge was the number of readmissions within the first year (OR: 1.20; 95% CI, 1.09\u20131.32).<\/p>\n

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Furthermore, patients experiencing an adverse change in employment were more likely to have depression at baseline compared with those experiencing no change (6.5% versus 4.5%; P: 0.04) and to have a continued increase in depression during follow-up and at 1 year (27.4% versus 16.7%; P<0.001). Moreover, patients with an adverse change in employment reported lower self-rated health status than those not experiencing any adverse change during follow-up (p\u2264 0.01).\u00a0Additionally, patients who were not working at baseline, had not retired, and who did not resume working by 1 year also reported significantly worse self-rated health status.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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This study showed that patients who experience an adverse change in employment are at increased risk of depression, lower quality of life, and increased financial hardship with medication costs compared with those who continue working. The authors also emphasised that approximately 50% of job losses were involuntary. Additionally, the strongest predictors of adverse change in employment were unplanned rehospitalizations and post-MI bleeding.<\/p>\n

To conclude, more support should be provided to patients to facilitate successful return to work. Further research is needed to address a patient-centered approach on employment and financial rehabilitation.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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Source:\u00a0Adverse Change in Employment Status After Acute Myocardial Infarction<\/a><\/p>\n

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Adverse change in employment after myocardial infarction (MI) is associated with a lower quality of life, increased depression and more difficulty affording medications according to a study that has been published in the June issue of\u00a0Circulation Cardiovascular\u00a0Quality and Outcomes\u00a0.<\/p>\n","protected":false},"author":18,"featured_media":4466,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"aside","meta":{"footnotes":""},"categories":[4],"tags":[47],"ppma_author":[1044],"class_list":{"0":"post-4418","1":"post","2":"type-post","3":"status-publish","4":"format-aside","5":"has-post-thumbnail","7":"category-acs","8":"tag-featured","9":"post_format-post-format-aside","10":"author-sargun-walia"},"authors":[{"term_id":1044,"user_id":18,"is_guest":0,"slug":"sargun-walia","display_name":"Sargun Walia, M.D.","avatar_url":"https:\/\/secure.gravatar.com\/avatar\/7cd5b8b1a0dbcbeb9dd74449aba6c0dcdb7625fab178ac23bed83e15d52b1c03?s=96&r=g","0":null,"1":"","2":"","3":"","4":"","5":"","6":"","7":"","8":""}],"_links":{"self":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/4418","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/users\/18"}],"replies":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4418"}],"version-history":[{"count":124,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/4418\/revisions"}],"predecessor-version":[{"id":4573,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/4418\/revisions\/4573"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/media\/4466"}],"wp:attachment":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4418"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=4418"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=4418"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fppma_author&post=4418"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}